犬环咽肌失弛缓症的手术治疗死亡率低但复发或持续临床症状发生率中等
Surgical management of cricopharyngeal achalasia in dogs results in low mortality but moderate incidence of recurrence or persistent clinical signs.
文献信息
| PMID | 42833263 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Rey M Zhang |
| 作者单位 | Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada. |
| 期刊 | American journal of veterinary research |
| SCI 分区 | Q2 |
| IF | 1.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 描述犬环咽肌失弛缓症（CA）的诊断和手术治疗，并识别可能影响术后结局的患者或管理因素。
方法： 回顾性收集信号ment、诊断影像学发现、手术信息、并发症和结局。使用Fisher精确检验和Wilcoxon秩和检验，以性别、品种、年龄、视频荧光吞咽研究结果、手术侧别和切除肌肉为变量，识别不满意结局的预测因素。
结果： 纳入2009年至2025年间接受手术治疗的26只CA犬。最常见的品种为贵宾混血犬（n=12）和金毛寻回犬（8只）。腹侧双侧手术的手术时间短于经两个侧切口的手术。术后并发症率和死亡率分别为23%和11.5%。吸入性肺炎是最常见的术后并发症。42.3%报告了不满意结局。34.6%在初始缓解后出现临床症状复发，26.9%进行了翻修手术。复发的中位时间为84天（范围，7至1,320天）。年龄、性别、品种、侧别、视频荧光吞咽研究结果或切除肌肉均未发现显著关联。
结论： CA的手术治疗死亡率低，复发和翻修手术发生率中等，且残留症状需要长期保守管理。
临床相关性： 手术是管理CA的安全选择，但应告知主人复发和残留临床症状的风险，可能需要长期饮食调整。CA动物在术前和术后均有吸入性肺炎风险，应相应监测。
英文摘要
OBJECTIVE: To describe diagnostic and surgical management of cricopharyngeal achalasia (CA) in dogs and to identify patient or management factors that may contribute to postoperative outcomes.
METHODS: Signalment, diagnostic imaging findings, surgical information, complications, and outcomes were retrospectively obtained. Fisher exact and Wilcoxon rank-sum tests were performed to identify predictors of unsatisfactory outcomes using sex, breed, age, videofluoroscopic swallow study findings, laterality of surgery, and muscles resected as variables.
RESULTS: 26 dogs surgically managed for CA from 2009 through 2025 were included. The most common breeds were Poodle mixes (n = 12) and Golden Retrievers (8). Ventral bilateral surgery resulted in shorter operative times than through 2 lateral incisions. Postoperative complication and mortality rates were 23% and 11.5%, respectively. Aspiration pneumonia was the most common postoperative complication. Unsatisfactory outcomes were reported in 42.3%. Recurrence of clinical signs after initial resolution was noted in 34.6%, and revision surgery was performed in 26.9%. Median time to recurrence was 84 days (range, 7 to 1,320 days). No significant association was identified for age, sex, breed, laterality, videofluoroscopic swallow study findings, or muscles resected.
CONCLUSIONS: Surgical management of CA resulted in low mortality, moderate incidence of recurrence and revision surgery, and residual symptoms requiring long-term conservative management.
CLINICAL RELEVANCE: Surgery is a safe option for management of CA, but owners should be informed of the risks of recurrence and residual clinical signs that may require long-term dietary modifications. Animals with CA are at risk of aspiration pneumonia both pre- and postoperatively and should be monitored accordingly.